What is the role of micronized dehydrated human amnion/chorion membrane (dHACM) injection in the treatment of plantar heel pain?

Updated: Oct 01, 2018
  • Author: Vinod K Panchbhavi, MD, FACS; Chief Editor: Thomas C Dowd, MD  more...
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Answer

In a randomized controlled trial, Cazzell et al compared micronized dehydrated human amnion/chorion membrane (dHACM) injection (one injection in the affected area; n = 73) with 0.9% sodium chloride placebo (n = 72) for the treatment of plantar fasciitis. [47] They assessed safety and efficacy at 4 weeks, 8 weeks, 3 months, 6 months, and 12 months post injection, using the Visual Analogue Scale (VAS) for pain, the Foot Function Index–Revised (FFI-R) score, and the presence or absence of adverse events. The primary outcome was mean change in VAS score between baseline and 3 months; the secondary outcome was mean change in FFI-R score between baseline and 3 months.

Baseline VAS scores in this study were similar between groups. [47] At 3 months, VAS scores in the treatment group had a mean reduction of 76% versus baseline, whereas those in the control group had a mean reduction of 45%. FFI-R scores in the treatment group had a mean reduction of 60% versus baseline, whereas those in the control group had a mean reduction of 40%. Of the four serious adverse events noted, none were related to study procedures. The authors concluded that the pain reduction and functional improvement outcomes were statistically significant and clinically relevant, supporting the use of micronized dHACM injection as a safe and effective treatment for plantar fasciitis.


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